A LONGITUDINAL STUDY ON SNAP PARTICIPATION AND SELF-REPORTED HEALTH AMONG DIABETIC AND NON-DIABETIC INDIVIDUALS

Abstract Self-reported health is a strong predictor of future health status, new morbidity, mobility decline, illness recovery, and healthcare utilization. Because self-reported health is rooted in social position and social comparison, it dually reflects individual health perceptions and health inequities, especially among those who experience a social struggle for resources. Food insecurity is associated with higher risk of chronic diseases and higher mortality rates. Interventions such as the supplemental nutrition assistance program (SNAP) were created to help address food insecurity. Although morbidity and mortality risks caused by food insecurity is exacerbated for those with nutrition-centered chronic disease, such as diabetes, limited research has assessed the impact of food insecurity and SNAP participation on health among diabetics. Using Health and Retirement Study data, we explore the effect of SNAP participation and food insecurity on the likelihood of reporting fair or poor health comparing 24,446 diabetes to 69,260 non-diabetics individuals aged 65 and above (2004-2020). Our analysis controls for key socioeconomic factors, including age, gender, race/ethnicity, and wealth, accounting for the complex design of HRS. Our key findings reveal that food insecure diabetics have significantly higher odds of reporting fair/poor health, and diabetic SNAP participants also had significantly higher odds of reporting fair/poor health. Our study demonstrates how food insecurity and diabetes concurrently influence health and how, despite the presence of resources, such as SNAP, there was no improvement in self-reported health. This study is important as it highlights the need for future research on the effects of SNAP participation and self-reported health.


Toppenish, Washington, United States
There is significant loss of dendritic complexity with age, which may account for synaptic loss and cognitive decline in mammals.However, molecular mechanisms underlying these changes are unclear.Key molecular players in dendritic morphogenesis include the guidance cue semaphorin 3A (Sema3A).In developing cortical neurons, Sema3A signals through the Plexin-A4 receptor to induce basal dendritic arborization, while another closely related member, Sema3F, induces apical dendritic spine pruning.Interestingly, both ligands are expressed in adulthood, but their roles in age-associated dendritic remodeling are unknown.To address this, we established a model of aging mouse primary cortical neurons: 5, 15, and 30 days-in-vitro (DIV) representing young, mature, and aged timepoints.Treating with either ligand increases branching at 5-15DIV, but not 30DIV, suggesting age-associated changes in cellular responses to Sema3A/3F.Next, we examined mouse cortices in vivo and found both Plexin-A4 expression and dendritic elaboration decrease with age, suggesting a need for Plexin-A4 to maintain dendritic complexity at older ages.In 6-month-olds, mutant Plexin-A4 mice have less branching than wildtypes, but we found no further decline in 18-month-olds, likely because there can be no age-associated downregulation of Plexin-A4 signaling if the receptor is not present.Finally, we found increased levels of active-RhoA GTPase (a downstream cytoskeleton regulator) in Plexin-A4-/-6-month-old cortices versus controls.Additionally, our preliminary data trends towards increased active-RhoA in 18-month-olds versus 6-month-olds.Collectively, our study provides novel insights into the diverse cellular functions of semaphorin-plexin, a signaling pathway important for nervous system development, in age-associated dendritic loss and cognitive decline.Healthy dynamic equilibrium between immune and endocrine function can be altered not only by illness but by changes in lifestyle including caloric intake.The Comprehensive Assessment of the Long-term Effects of Reducing Intake of Energy Study (CALERIE™) is a large multi-year longitudinal study funded by the National Institute on Aging investigating what metabolic adaptations would result from a 25% caloric restriction sustained for 2 years and how these might positively affect primary aging and inform on aging biomarkers and chronic diseases of aging.A broad range of behavioral and physiological markers were measured at different levels of biology, making comprehensive integration and interpretation of data challenging.Here we propose a knowledgebased framework for integrating data that fully applies our current understanding of biobehavioral regulatory biology.Leveraging the Elsevier Knowledge Graph and the MedScan Natural Language Processing (NLP) engine we extracted from peer-reviewed literature 816 documented regulatory relationships linking a subset of 85 data elements readily available, including ~ 15 immune inflammatory and 12 endocrine markers.With a connection density of ~11%, this network was supported by > 23,000 citations or a median of 7 citations per regulatory interaction.A structural analysis of connectivity patterns identified inflammatory marker CCL2, insulin and testosterone as key mediators of large-scale coordinated response to caloric restriction.Ongoing analysis will identify immune and endocrine decisional logic that drives network dynamics, providing candidate intervention targets potentiating caloric restriction that remain explainable in the context of established pathway biology.
individual health perceptions and health inequities, especially among those who experience a social struggle for resources.Food insecurity is associated with higher risk of chronic diseases and higher mortality rates.Interventions such as the supplemental nutrition assistance program (SNAP) were created to help address food insecurity.Although morbidity and mortality risks caused by food insecurity is exacerbated for those with nutrition-centered chronic disease, such as diabetes, limited research has assessed the impact of food insecurity and SNAP participation on health among diabetics.Using Health and Retirement Study data, we explore the effect of SNAP participation and food insecurity on the likelihood of reporting fair or poor health comparing 24,446 diabetes to 69,260 non-diabetics individuals aged 65 and above (2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015)(2016)(2017)(2018)(2019)(2020).Our analysis controls for key socioeconomic factors, including age, gender, race/ethnicity, and wealth, accounting for the complex design of HRS.Our key findings reveal that food insecure diabetics have significantly higher odds of reporting fair/poor health, and diabetic SNAP participants also had significantly higher odds of reporting fair/poor health.Our study demonstrates how food insecurity and diabetes concurrently influence health and how, despite the presence of resources, such as SNAP, there was no improvement in self-reported health.This study is important as it highlights the need for future research on the effects of SNAP participation and self-reported health.

A META ANALYSIS ON THE ASSOCIATION OF NOVEL PLASMA BIOMARKERS TESTING FOR EARLY DETECTION OF ALZHEIMER'S DISEASE Charles Dunnam, Wichita State University, Wichita, Kansas, United States
The latest research confirms the heterogeneity of Alzheimer's Disease Related Dementia (ADRD).This justifies a metaanalysis study on the association of novel plasma biomarkers with screening assessments for early detection of ADRD.The conceptual framework model will be analyzed from the 2020 edition of the GSA KAER Toolkit with updates.The purpose of the current study is two-fold.First, to determine the need of a universal protocol method for early assessment of ADRD by primary care teams.Second, implementation of Food and Drug Administration (FDA) approved novel plasma biomarkers testing as a follow-up protocol to a screening assessment.The two suggested protocols have recently established Medicare coverage.The study will conclude with an extensive review of the known novel plasma biomarkers that are available for testing, at present and a brief overview of available screening assessments for early detection of ADRD.

A MIXED METHODS APPROACH TO UNDERSTANDING SPOUSE AND CHILD CAREGIVERS' EXPERIENCES OF LUCID EPISODES IN DEMENTIA
Kyungmin Kim 1 , Lauren Bangerter 2 , Dawne Finnie 3 , Joseph Gaugler 4 , Lapid Maria 3 , Theresa Frangiosa 5 , and Joan Griffin 3 , 1. Seoul National University, Seoul, Republic of Korea,2. Medstar Health,Minneapolis,Minnesota,United States,3. Mayo Clinic,Rochester,Minnesota,United States,4.University of Minnesota, Minneapolis, Minnesota, United States,5. Faerge Drinker,Washington,District of Columbia,United States Lucid episodes (LE) in people living with late-stages of dementia (PLWD) have been reported anecdotally, but less is known about how this seemingly unexpected phenomenon is experienced by family members.This study aims to examine variability in family caregivers' experiences with LE, focusing on the two most common groups of informal caregivers, spouses and children-whether they may exhibit differential appraisals of and responses to LEs.Using a sample of former and current family caregivers from UsAgainstAlzheimer's A-LIST, we conducted an online survey to spouse and child caregivers (N = 387).Qualitative semi-structured interviews were also conducted with a subset of these caregivers who have witnessed an LE (n = 22).Survey results indicate that child caregivers were more likely to witness a LE.Among "former" caregivers who have witnessed a LE (n = 140), spouses were likely to appraise LEs more negatively and make changes in care decisions (i.e., end-of-life planning and financial decisions) after LE, compared to child caregivers.Among "current" caregivers who have witnessed a LE (n = 80), spouses were more likely to indicate no special circumstances prior to LE, whereas children were more likely to indicate LEs associated with visits from friends and family; there was no difference in positive and negative appraisals of LE between current spouse and child caregivers.Content analysis of qualitative interviews revealed that observed differences between spouses and children were related to their different caregiving contexts, such as relationship history, living arrangement, expectations/ motivation, and care resources.

A NEW METHOD TO IDENTIFY MEDICARE CLAIMS-BASED FACTORS ASSOCIATED WITH POST-ACUTE RECOVERY IN OLDER ADULTS WITH ADRD
Chixiang Chen 1 , Biyi Shen 2 , Jason Falvey 1 , Michelle Shardell 1 , and Haoyu Ren 3 , 1. University of Maryland School of Medicine,Baltimore,Maryland,United States,2. Regeneron,Ellicott City,Maryland,United States,3. University of Maryland,Baltimore County,Baltimore,Maryland,United States Nearly 300,000 older adults experience a hip fracture every year, the majority of which occur following a fall.Unfortunately, recovery from hip fracture is poor, where older adults diagnosed with Alzheimer's Disease and Related Dementia (ADRD) spend a particularly long time in hospitals or rehabilitation facilities during the post-operative recuperation period.Because older adults value functional recovery and spending time at home versus facilities as key outcomes after hospitalization, identifying factors that influence days spent at home after hospitalization is imperative.However, few rigorous analytical approaches are available to help overcome potential sources of analysis bias such as hospital-level unmeasured confounders, informative hospital size, and loss to follow-up due to death.To overcome these challenges, we developed a new data science approach equipped with unsupervised learning to simultaneously handle statistical complexities that are often encountered in research using large administrative claims databases.The proposed approach is